Understanding abdominal pain Flashcards
Epigastric pain which moves to RUQ, what is your most likely diagnosis?
Cholecystitis
Epigastric pain which moves to your back, what is your most likely diagnosis?
Pancreatitis
Periumbilical pain which moves to RIF, what is your most likely diagnosis?
Appendicitis
Periumbilical pain which moves lower, what is your most likely diagnosis?
Meckels diverticulitis
Lower abdominal pain which moves to LIF, what is your most likely diagnosis?
Diverticulitis
Epigastric pain which moves to RIF, what is your most likely diagnosis?
Perforated duodenal ulcer
How would a patient describe a colicky pain? What is the cause of this? Differential diagnoses?
‘Comes and goes’ - ‘comes in waves’
- Hollow muscular structure/tube with exaggerated contractions to unblock itself causing pain
- Bowel colic, biliary colic, ureteric colic, in labour
Different differential diagnoses for acute abdominal pain that is non-colicky/persistent
INFLAMMATORY PROCESS
- Acute cholecystitis
- Appendicitis
- Gastritis
- Pancreatitis
- Diverticulitis
- Colitis
How could pain move from colic to …itis and vice versa?
Initial gallbladder obstruction with stone = biliary colic, later the gall bladder can become inflamed = cholecystitis. If the gallstone has passed and obstructs the small bowel = SB colic, then if it perforates the small bowel = peritonitis
How could pain move from colic to …itis and vice versa?
Initial gallbladder obstruction with stone = biliary colic, later the gall bladder can become inflamed = cholecystitis. If the gallstone has passed and obstructs the small bowel = SB colic, then if it perforates the small bowel = peritonitis
GI tract pathology signs and symptoms
- Vomiting
- Weight loss
- Fever
- Bowel changes
- Bleeding
Different reasons for abdominal pain which are not GI related?
- PV bleeding, dysmenorrhoea = Gynae
- Fever, frequency, UTI, bleeding = Urology
- Dizziness, sweaty, palpitations = Vascular
- Hiatus hernia: presents as chest pain
- Strangulated hernia: tender bowels in hernia sac
- Referred pain: testicular torsion, herpes zoster
- Abdominal wall: bruising, haematoma, MSK
What is McBurney’s point?
1/3 of the way between ASIS and umbilicus
Differential diagnoses for RIF pain
- Gynae
- Ovarian cyst rupture
- Retrograde menstruation
- Mid cycle pain
- Endometriosis
- Ectopic pregnancy - GI
- Enteritis
- TB
- Yersinia infection
- Colitis
- Malignancies
- Hernia
- Diverticulitis
- Meckels
- Gastroenteritis - Renal
- Ureteric colic - Other
- Herpes zoster
- Mesenteric adenitis
- MSK
- Functional
NOTE SLIDE: RUPTURED ABDOMINAL AORTIC ANEURYSM, RUPTURED SPLEEN OR OTHER ANEURYSM ARE DIFFERENTIAL DIAGNOSIS FOR ACUTE ABDO PAIN W/DIZZINESS AND LOSS OF CONSCIOUSNESS
:)
